Infantile and juvenile scoliosis

The diagnosis and treatment of scoliosis in the growing child is a challenging endeavor. It is crucial that the correct diagnosis be established initially. Early referral and treatment is imperative. Careful follow-up is mandatory. If a deformity is proved to be progressive despite bracing, surgical intervention is likely to be necessary. Because significant truncal shortening is an issue with early spinal fusion, a young child may benefit from instrumentation without fusion. Ultimately, however, definitive spinal fusion must be performed. The use of posterior spinal fusion alone results in gradual clinical deterioration most often secondary to the crankshaft phenomenon. Anterior growth arrest appears to be promising in preventing this complication. Careful and diligent treatment can effectively control spinal deformities in these young children.